ABSTRACT More than 20 million elderly people in the US have significant hearing loss but only 20% use hearing aids. Of these, 35 - 50% are dissatisfied with them, which often results in the hearing aids being returned within the trial period or left in-the-drawer. With untreated hearing loss resulting in a 200% - 300% increase in the risk of dementia, depression, and falls, and severe communication difficulties with family members and friends, it is imperative that older adults are not only screened for hearing loss and, when appropriate, fit with hearing aids, but that steps are taken to ensure patients' acceptance and proper use of, and continued satisfaction with the hearing aids. Alternative approaches for patient education and training have included DVDs (which are neither individualized nor interactive and have met with limited success), and the Internet, which is used by only 35% of people over age 65. This Phase I SBIR study will focus on older people with hearing loss who are not technology-savvy. We propose an innovative, interactive patient-centered product that builds on the home TV - which people age 65 and older watch an average of 49 hrs/week. By simply using a TV remote control, patients will view short educational videos on demand and avail themselves of other innovative and beneficial patient-centered features that are very easy to use. In addition, the audiologist will receive data on the patients' learning and behavioral experiences to further individualize aftercare. This interactive TV approach is consistent with vision articulated by Apple Computer founder Steve Jobs, who said shortly before his untimely death, I'd like to create an integrated television set that is completely easy to use. Our hypothesis is that the interactive TV system and content developed in this project will appeal to the targeted subgroup of patients age 60 and older, resulting in improved use of and satisfaction with their hearing aids. We also believe it will appeal to the audiologist who will use his/her time more effectively. The Phase I study will develop the interactive TV technology and comprehensible hearing aid education and training videos, and then conduct a pilot test with 30 subjects. The aims of the pilot test are to demonstrate patients' and audiologists' ease of use and satisfaction with the new system as well as improved hearing experiences as measured by two standardized instruments: the APHAB and the COSI. In Phase II, HTM will improve the product design, develop additional content based on the lessons from Phase I, and then conduct a randomized controlled trial to quantify the benefits to patients, family members, audiologists, and manufacturers. Following Phase II, HTM's sales team plans to sell or license this interactive system to retail hearing centers nationwide.